Partner/Nominator Customer Satisfaction Survey for the Evidence Based Practice Center (EPC) Division

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery

OMB: 0935-0179

IC ID: 235082

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Form and Instruction
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Partner/Nominator Customer Satisfaction Survey for the Evidence Based Practice Center (EPC) Division
 
Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 1 Nominator/Partner Survey Customer Satisfaction Survey_Partner_Nominator_DRAFT REVISED _02222019.docx Yes Yes Fillable Fileable

Health Health Care Services

 

20 0
   
Private Sector Businesses or other for-profits, Not-for-profit institutions
 
   50 %

  Requested Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 20 0 0 0 0 20
Annual IC Time Burden (Hours) 20 0 0 0 0 20
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Supporting Statement Generic Clearance Submission Partner Interview_10292018 (1).doc 02/22/2019
Cover Letter OMB Cover Letter.doc 02/22/2019
Invitation NewParnterEmailInvitation_rev.docx 02/22/2019
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.
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